Phototherapeutic keratectomy in patients with recurrent corneal epithelial erosions

PURPOSE: To evaluate the outcome of phototherapeutic keratectomy (PTK) in the management of recurrent corneal erosions, refractory to other forms of treatment. METHODS: Phototherapeutic keratectomy was performed on 43 eyes of 41 patients with recurrent corneal erosions. The corneal epithelium was debrided, and laser ablation was performed to a depth of 6 mum with an ablation zone of 7 to 9 mm, using the Technolas Keracor 117C PlanoScan excimer laser. Follow-up time was 12 to 48 months (mean, 23.3 +/- 9.1 mo). RESULTS: After PTK, patients were free of symptoms in 31 eyes (72.1%), and eight eyes (18.6%) had occasional mild symptoms of irritation and photophobia upon awakening. Recurrence of painful corneal erosions occurred in four eyes (9.3%). After PTK retreatment, these patients did not report any further episodes and were free of symptoms for 12 to 30 months (mean, 21.0 +/- 7.7 mo). The mean spherical equivalent manifest refraction was changed by +0.15 +/- 0.39 D in the hyperopic direction at I year after PTK. Thirty-three eyes (76.7%) were within tl line of preoperative best spectacle-corrected visual acuity (BSCVA). BSCVA was improved by two or more lines in 10 eyes (23.3%). There were no significant complications. CONCLUSION: Excimer laser PTK with the Technolas Keracor 117C excimer laser was a safe and effective procedure for the treatment of recurrent corneal erosions. Excimer laser PTK can also be useful in improving the visual acuity in these patients. A small percentage of patients may require a second PTK to prevent further episodes of corneal erosions.